Australia gets an F for sexual and reproductive health
Last week Melbourne based Professor of reproductive biology Roger Short reminded us that uncontrolled global population growth is a major contributor to “human activity outstripping the natural world’s ability to cope.”
This was one of the conclusions of a Scientific Forum at the University of California recently, which found “…that rapid population growth combined with massively increasingly use of fossil fuels was exhausting the earth’s capacity to support life.”
Professor Short wisely called for increased access to contraception in developing countries to “to empower women to reduce fertility”.
This, of course, is not a new concept. In 1992 James Grant of UNICEF stated that “Family Planning could provide more benefits to more people at less cost than any other single technology now available to the human race.”
More recently, prominent economists such as Professor Jeffrey Sachs (former director of the UN Millennium Project which aims to halve world poverty by 2015) reiterated that a move to lower fertility rates will mean healthier mothers and children, increased opportunities for education for women, therefore a faster growth in living standards and reduced environmental stressors.
There are, of course, many complex factors making this difficult, but the Australian Government is not helping by leaving in place their restrictions on aid programs which do not allow Australian aid programs to talk about, advise on or provide services related to terminating unwanted pregnancies, leaving women to seek dangerous, unsanitary methods often leading to their deaths.
Professor Short also reminds us that there is a lot that needs to be done in our own backyard.
Australia fares quite badly on s-xual and reproductive health indicators. Australia has among the highest rates of teenage pregnancy and abortion among developed nations.
The rate of births to teenagers in Australia is 18.4 per 1,000 females of reproductive age, much higher than Korea (2.9) or Switzerland (5.5), although lower than the UK (29.7) and the USA (51.1). Teenage motherhood is associated with a range of poor social, economic and health outcomes.
Over the last decade in Australia, rates of Chlamydia have increased more than fourfold, with the majority of cases affecting young women, potentially leading to infertility. Other s-xually transmissible infections, including HIV are on the rise in Australia, among a range of population groups.
S-xual violence, childhood abuse, drugs and alcohol, as well as social, cultural and socio-economic factors all play a role in s-xual behaviour, but fundamentally, young people need access to accurate, unbiased, age-appropriate information.
In the Netherlands, young people receive comprehensive s-xuality education throughout their schooling and can easily access contraception at little or no cost. According to the International Planned Parenthood Foundation, these initiatives have produced the best s-xual and reproductive health outcomes in the world.
In October last year it was reported that England is to introduce compulsory s-x and relationships education into the school curriculum in primary and secondary schools by 2010 in an effort to reduce teen pregnancies and s-xually transmissible diseases. Australia has no consistent curriculum, compulsory or otherwise. Most education Ministers in the States and Territories have no idea what, if any, s-xuality and relationships education is taught in each school.
Access to a full range of contraception is not available in many parts of Australia and community awareness of contraceptive methods, particularly emergency contraception (the “morning-after pill”) is low.
We do not, however, need a special parliamentary committee as Professor Short suggests. Last year the Public Health Association of Australia, the Australian Reproductive Health Alliance and S-xual Health and Family Planning Australia jointly presented the Government with a comprehensive report on the state of s-xual and reproductive health in Australia, and a framework for developing a National S-xual and Reproductive Health Strategy. The all party Parliamentary Group on Population and Development continues to lobby for this strategy.
The evidence is there. All we need is for the Australian Government to act.
Jenny Ejlak is the Convenor, Women’s Health Special Interest Group, at the Public Health Association of Australia.